The film is primarily dealing with perfection, the need to be perfect. It is was Nina says to Thomas when she asks for the lead role, "I want to be perfect." But, what does this mean? And, when Thomas says to "lose yourself" it is taken by Nina in a way that creates more horror in her life in order to achieve this perfection than anything else. This film describes the neurosis of many artists who believe that the only way to "go there" is to become obsesses and overwhelmed by the pain, when in reality the letting go when combined with discipline creates truth, being, something that cannot be faked. Nina finds this in her performance, but at what cost?
The price Nina pays, potentially, is with her life. Is any role worth that price? And, for what? These are questions that Aronofsky raises with this story. We champion and cheer Nina like the audience at the Lincoln Center for her flawless performance, but once the applause fades what is left but a woman bleeding, needing approval more than another breath.
This story reveals the horrors of giving into the belief that the creation of art must be tragic. There is transcendence in art, and one must live in order to find it, otherwise there is no one left to perform and share their gifts with the world. The dark side consumes Nina and she is overtaken. Is this perfection? To Thomas it is. And this reveals the need for human beings to be loved and accepted by others in order to know who they are, rather than knowing who they are and living from there. It is a beautifully tragic film about the realities of an artist working from pain and trauma in order to find greatness, perfection.